Re: p medicine concept

[Guest guest]

Dear members,

Entire gravity of

p medicine selection process is on developing a logical approach, and it allows

for clinicians to develop personal choices in medicines (a personal formulary)

which they may use regularly. The program seeks to promote appraisal of

evidence in terms of proven efficacy and safety from controlled clinical trial

data, and adequate consideration of quality, cost and choice of competitor

drugs by choosing the item that has been most thoroughly investigated, has

favorable pharmacokinetic properties and is reliably produced locally. The

avoidance of combination medicines is also encouraged.

Regards,

Dr. Chaitali

Nagpur

[Guest guest]

Hi Chaitali,

We started teaching " p " medicine concept to introduce rational

therapeutics.

But unfortunately the materialistic medicos have reduced

the " personal formulary " to be based on economic consideration

derived from free medicine samples, gifts, schemes based on

prescription quantum,discounts and commissions from pharmaceutical

companies.

Because there are doctors willing to be corrupted, the corruption

in " p " medicine prevails, thrives, throbs, prospers, multiplies and

seems contagious.

Vijay

>

>

>

>

>

> Dear members,

>

> Entire gravity of

> p medicine selection process is on developing a logical approach,

and it allows

> for clinicians to develop personal choices in medicines (a

personal formulary)

> which they may use regularly. The program seeks to promote

appraisal of

> evidence in terms of proven efficacy and safety from controlled

clinical trial

> data, and adequate consideration of quality, cost and choice of

competitor

> drugs by choosing the item that has been most thoroughly

investigated, has

> favorable pharmacokinetic properties and is reliably produced

locally. The

> avoidance of combination medicines is also encouraged.

>

>  

>

> Regards,

>

>  

>

> Dr. Chaitali

>

> Nagpur

>

>  

>

[Guest guest]

Dear Vijay sir,

In all the talk of rational medicine use and p medicine concept, the impact of the pharmaceutical industry cannot be ignored, with its many incentive schemes to encourage the use of their product such as distributing free samples, gifts, sponsored trips or training courses. Although it is sometimes delicate to draw the line between marketing and corruption, such practices and "money warped behavior" of doctors can endanger patients' health.

The only alternatives are to ensure practitioners have the skills to appraise medicine promotion activities or to more stringently control pharmaceutical promotional activities which include banning practices of gift and sponsorship, following WHO ethical guidelines on medicines promotion, and promoting codes of ethics in marketing through trade and professional organizations.

The practice of "academic detailing" or user-friendly educational outreach programs can help provide noncommercial sources of drug information and has been proven effective at influencing prescribing patterns in a way that benefits public health objectives.

Regards,

Chaitali

> >> > > > > > > > > > Dear members,> > > > Entire gravity of> > p medicine selection process is on developing a logical approach, > and it allows> > for clinicians to develop personal choices in medicines (a > personal formulary)> > which they may use regularly. The program seeks to promote > appraisal of> > evidence in terms of proven efficacy and safety from controlled > clinical trial> > data, and adequate consideration of quality, cost and choice of > competitor> > drugs by choosing the item that has been most thoroughly > investigated, has> > favorable pharmacokinetic properties and is reliably produced > locally. The> > avoidance of combination medicines is also encouraged. > > > > > > > > Regards,> > > > > > > > Dr. Chaitali> > > > Nagpur> > > > > >>

[Guest guest]

Hi,

In continuation of my charge here is post from E-drug which appeared

today. Copied as fair use.

Vijay

-----------------------------------------------------------------

E-DRUG: UBC researchers map billions in spending on prescription

drugs

-----------------------------------------------------------------

E-drug readers might be interested in this report which has just

been released.

A Canadian research team at the University of British Columbia has

just released the 2nd Edition of the Canadian Rx Atlas. This atlas

provides the most comprehensive depiction of the nature, magnitude

and causes of prescription drug spending in Canada to date.

The study, which draws on data from IMS Health and other sources,

reveals some very interesting findings about age-standardized

interprovincial variations in prescription drug use and spending.

The complete study and set of downloadable graphics are available

online for educational and non-commercial use.

http://www.chspr.ubc.ca/rxatlas/canada

The team was lead by Dr. Steve , PhD, Associate Professor &

Associate Director, Centre for Health Services and Policy Research,

University of British Columbia (morgan@...).

A UBC press release is provided below.

Best regards,

Ciprian Jauca

Program Coordinator

Therapeutics Initiative

University of British Columbia

jauca@...

+1-604-822-0700

www.ti.ubc.ca

MEDIA RELEASE | DECEMBER 19, 2008

UBC researchers map billions in spending on prescription drugs

Researchers at The University of British Columbia's Centre for

Health Services and Policy Research (CHSPR) have released the most

comprehensive study of drug spending in Canada to date. The Canadian

Rx Atlas (2nd Edition) is the first ever that measures spending on

prescription drugs by province, therapeutic category, and age of

patient.

" The results show major differences in the use and cost of medicines

across Canada, " says Steve , associate director in UBC's

CHSPR. " Across provinces spending differs by more than 50 per cent.

The most striking finding however, is that none of the conventional

beliefs about drug spending appear to be true. "

The study reveals that spending is not due to differences in

population age, provincial drug plan formularies, population health

status, or health system characteristics.

According to , many variations in the amount of medicines used

and the type of medicines prescribed are driven by non-medical

causes including differences in the expectations of patients and

prescribing habits of physicians.

Key Findings

In 2007, Canadians spent $578 per capita on retail purchases of

prescription drugs, approximately $19 billion in total.

On average, spending on prescriptions for Canadians age 65 and older

was more than twice that of Canadians aged 45–64 and over six times

that of Canadians aged 20–44.

After figures were adjusted for differences in population age,

spending per capita varied by over 55% across provinces, from $418

in British Columbia to $655 in Quebec.

Differences in the number of drugs covered by provincial drug plans

do not appear to explain inter-provincial variations in prescription

drug spending.

Population characteristics such as socioeconomics, health status,

and health system do not point to clear explanations of inter-

provincial variations in age-standardized spending.

UBC researchers combined unique databases from IMS Health Canada, an

international health industry information company, with other

sources of information about provincial populations and health

systems. The report is now available at www.chspr.ubc.ca.

" The findings of the Canadian Rx Atlas underscore the importance of

efforts to build better data systems for monitoring pharmaceutical

utilization, expenditures, and health outcomes, " says . " Our

Atlas shows that for several age groups and drug classes, residents

in some provinces use 50 per cent more medicines than residents of

other provinces. It is long overdue that we study these patterns to

determine whether this reflects over use of medicines in some

provinces or underuse in others. "

This second edition of the Canadian Rx Atlas features 168 full-

colour maps detailing drug spending levels and causes in the

provinces, 20 maps illustrating population health and health systems

in the provinces, and 42 illustrations of average drug spending per

person within major age groups.

" Our new Atlas gives policy makers, researchers and the public

unparalleled information about factors that drive spending on

prescription drugs, " says Steve .

The UBC Centre for Health Services and Policy Research stimulates

scientific enquiry into population health and into ways in which

health services can best be organized, funded and delivered.

IMS Health provided data for the study. It operates in more than 100

countries and is the world's leading provider of information

solutions to the pharmaceutical and health-care industries.

-30-

UBC Public Affairs

310 – 6251 Cecil Green Park Rd.

Vancouver B.C. Canada V6T 1Z1

www.publicaffairs.ubc.ca

Contacts:

Loiacono

UBC Public Affairs

Tel: (604) 822-2644

E: catherine.loiacono@...

> > >

> > >

> > >

> > >

> > >

> > > Dear members,

> > >

> > > Entire gravity of

> > > p medicine selection process is on developing a logical

approach,

> > and it allows

> > > for clinicians to develop personal choices in medicines (a

> > personal formulary)

> > > which they may use regularly. The program seeks to promote

> > appraisal of

> > > evidence in terms of proven efficacy and safety from controlled

> > clinical trial

> > > data, and adequate consideration of quality, cost and choice of

> > competitor

> > > drugs by choosing the item that has been most thoroughly

> > investigated, has

> > > favorable pharmacokinetic properties and is reliably produced

> > locally. The

> > > avoidance of combination medicines is also encouraged.

> > >

> > >

> > >

> > > Regards,

> > >

> > >

> > >

> > > Dr. Chaitali

> > >

> > > Nagpur

> > >

> > >

> > >

> >

>

[Guest guest]

Hi Chaitali,

No laws are going to work unless the pprescribers have the built in

self checks.

As regards observence of WHO ethical criteria, I feel that it is

time to rewrite what was written in 1988. Over the decades the

prescription world has changed. It desperately needs to be updated.

It is a tragic comedy when the name/emblem of the recommendary

organisation that recommends ethical criteria is unethically used in

promotional activites by pharma industry. Do watch out for

forthcoming issue of Indian Journal of Medical Ethics for our

detailed research report exclusively on this aspect.

Vijay

> > >

> > >

> > >

> > >

> > >

> > > Dear members,

> > >

> > > Entire gravity of

> > > p medicine selection process is on developing a logical

approach,

> > and it allows

> > > for clinicians to develop personal choices in medicines (a

> > personal formulary)

> > > which they may use regularly. The program seeks to promote

> > appraisal of

> > > evidence in terms of proven efficacy and safety from controlled

> > clinical trial

> > > data, and adequate consideration of quality, cost and choice of

> > competitor

> > > drugs by choosing the item that has been most thoroughly

> > investigated, has

> > > favorable pharmacokinetic properties and is reliably produced

> > locally. The

> > > avoidance of combination medicines is also encouraged.

> > >

> > >

> > >

> > > Regards,

> > >

> > >

> > >

> > > Dr. Chaitali

> > >

> > > Nagpur

> > >

> > >

> > >

> >

>

[Guest guest]

Dear members,

Please go through

an article- “Should medical students

learn to develop a personal formulary?” attached herewith.

Regards,

Dr. Chaitali

Nagpur

[Guest guest]

Dear Members,

Indicators of good prescribing

Most doctors have

a ¡personal formulary¢ of medications

from which they usually choose when prescribing. One study looked at the extent

to which general practitioners in Australia restricted the number of

therapeutic agents they prescribe. It examined concordance with standards based

on established guidelines or recognized good prescribing measures, and assessed

the potential of these measures as indicators of the quality of prescribing.. Prescription

data were obtained from the Australian Health Insurance Commission for over

15,000 GPs. It was found that with non-steroidal antiinflammatory

drugs (NSAIDs), GP

concordance with a personal formulary of up to five NSAIDs was high.

Concordance with a specified medicine standard for antibiotics (the Australian

Antibiotic Guidelines) increased substantially over time but was largely due to

increased prescribing of two heavily-promoted drugs. Most GPs restricted prescribing

of beta-blockers to two (atenolol and

metoprolol) but

used all five calcium-channel blocking drugs available. The authors concluded

that Australian GPs do use ¡personal formularies¢. However, they comment that

prescribing standards based on numbers of drugs used may not always reflect

rational prescribing choices. Measures based on personal formulary use are

potentially useful as prescribing indicators but need to be defined and interpreted

carefully. GPs should be encouraged to identify their personal formularies and

to review the medicines included in them. (copied from- www.ukmicentral.nhs.uk)

Regards,

Dr. Chaitali,

Nagpur.

[Guest guest]

Dear Smita,

Thanks for taking an active part in this discussion.

Yes, by promoting `p' drug concept among students (future doctors), medical practioners and lay people, one can keep check on erroneous drug promotion by pharma industry.

The emphasis is on learners building own personal formulary of preferred drugs for specific conditions so that they can prescribe confidently and rationally.

Regards,

Dr. Chaitali

> > From: chaitali bajait chaitali_bajait@...> Subject: Re: p medicine concept> netrum > Date: Saturday, 20 December, 2008, 10:30 PM> > > > > > > > > > > > Dear members,> Please go through an article- “Should medical students learn to develop a personal formulary?†attached herewith.>  >  > Regards,>  > Dr. Chaitali> Nagpur> > > > > > > > > > > > > > > > Explore your hobbies and interests. Go to http://in.promos./groups/>

[Guest guest]

Dear Members,

Resources for Better Prescribing-

Web sites:

American Family Physician STEPS collection,

http://www.aafp.org/afp/steps (free access)

MerckMedicus, http://www.merckmedicus.com (free access)

The Medical Letter, http://www.medicalletter.org (requires a

subscription)

Prescriber's Letter, http://www.prescribersletter.com (requires a

subscription)

Software for handheld computers

s Hopkins Antibiotic Guide, http://hopkins-abxguide.org (free

access)

Epocrates, http://www.epocrates.com (free and some sections require

subscription)

Tarascon Pharmacopeia, http://www.tarascon.com (requires a

subscription)

Drug Guide for Physicians, http://www.skyscape.com (requires a

subscription)

Micromedex, http://www.micromedex.com (requires a

subscription)

Use Computers and Other Tools to Reduce Prescribing Errors:

Optimal use of first seven Guidelines of

World Health Organization's (WHO) Guide to

Good Prescribing requires a working knowledge of current medications and

keeping up to date on new drugs. The websites described above provide more

objective, evidence-based data than pharmaceutical representatives or

advertisements. Given the pace of change in pharmacotherapeutics, physicians

should use continuously updated software for their handheld or desktop

computers and are strongly advised to consider using electronic prescribing

programs.

Physicians also can access therapeutic guidelines from sources like the

National Guideline Clearinghouse, which can be found at http://www.guidelines.gov. These sources provide clear statements

about the strength of evidence supporting their recommendations. Evidence

indicates that many new medications offer little or no benefit over drugs that

may already be in a personal formulary. More than 10 percent of new drugs on

the market in the last 25 years have earned a black box warning or have been

withdrawn from the market. For this reason, physicians should not prescribe new

medications until they have been demonstrated to be safer or more effective at

improving patient-oriented outcomes than existing drugs.

When evaluating new drug studies, physicians should look for evidence

that the new drug also improves patient-oriented outcomes more than older

drugs, and not just more than placebo.

Regards,

Dr. Chaitali,

Nagpur.